Civil society participation in the WHO GBV Global Action plan development

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1 FEEDBACK FROM: Gladness Hemedi Munuo TAMWA Crisis Resolving Centre Coordinator Tanzania Media Women s Association (TAMWA) Facilitating the participation of civil society and experts working on SRH, gender equality, human rights and VAW in the consultation processes to develop the WHO global plan of action on strengthening the role of the health systems in addressing interpersonal violence, in particular against women and girls and against children. Background: In May 2014, the World Health Assembly approved Resolution 67.15: Strengthening the role of the health systems in addressing violence, in particular against women and girls and against children. The Resolution (WHA 67.15) asks the Director-General to develop, with the full participation of Member States, and in consultation with United Nations organizations, and other relevant stakeholders focusing on the role of the health system, as appropriate, a draft global plan of action to strengthen the role of the health system within a national multisectoral response to address interpersonal violence in particular against women and girls and against children, building on existing relevant WHO work. In response to this request, the WHO Department of Reproductive Health and Research (RHR), with the Department of Non-communicable diseases, Violence and Injury Prevention (NVI), is leading a process of consultations with Member States and other relevant stakeholders in developing the draft Global Plan of Action. A draft discussion paper/draft zero of the Global Action Plan has been developed, which will be the basis for discussions at the regional and other consultations. The draft zero sets three specific areas of focus in setting out the objectives and specific recommendations to States, the WHO secretariat as well as global targets in addressing; i. Actions across different forms of violence ii. Violence against women and girls iii. Violence against children Level: 1 + Numbering Style: i, ii, iii, + Start at: 1 + Alignment: Left + IWHC has developed a set of key messages based on some of the gaps identified in the draft Global Plan of Action to guide civil society advocacy with governments and engagement throughout the consultation process. This first WHO global plan of action provides an unprecedented opportunity to strengthen the capacity of health systems to: provide comprehensive health services to survivors; implement prevention programmes; generate better evidence; 1

2 and advocate for a strong multisectoral response based on the public health evidence. Please go to the public website where the draft plan has been posted and provide feedback on the plan using the address: violencegap@who.int Please note that the deadline to provide this feedback is June 4, This process is incredibly important in strengthening health systems to respond and prevent violence against women and girls. Key Statistics: 1 Over 35% of women worldwide have experienced either physical and/ or sexual intimate partner violence (IPV) or non-partner sexual violence. Globally 7% of women have been assaulted by someone they do not know. 42% of women who have been physically or sexually abused by a partner have experienced injuries as a result of the violence. Globally, and particularly in sub-saharan Africa, the observed high rates of HIV infection in women have brought into sharp focus the problem of violence against women. Globally as many as 38% of all murders of women are committed by intimate partners. 1 out of 3 women worldwide have experienced rape or sexual assault. Sexual violence is often viewed as being inevitable in conflict situations. In addition to facing different forms of child maltreatment, girls also face specific forms of violence that are rooted in gender discrimination and harmful traditional practices including female genital mutilation (FGM) and child, early and forced marriage. More than 67 million women who are currently aged years are estimated to have been married before they reached the age of 18. More than 125 million girls and women today have undergone FGM. 1 in 5 women and 1 in 10 men report having been sexually abused as a child. 1 in 4 of all adults report having been physically abused and 36% have experienced emotional abuse as children Key messages 2 : Objective 1: Strengthen leadership, advocacy and governance of the health system in addressing violence Violence against women and girls is an endemic violation of human rights, not least the sexual and reproductive rights of women and girls. Violence seriously jeopardizes the physical and mental health of women and girls, including in many instances their sexual and reproductive health. It has far reaching and negative impact of children, families and the wider community and may also result in women's deaths, including by suicide. Protection of sexual and reproductive health and rights is thus central to the prevention and mitigation of violence against women and girls. 1 World Health Organization, Global and Regional Estimates of Violence Against Women (Geneva: 2013). 2 These key messages are based on the objectives and gaps identified in the draft global plan of action. Some of the messages are informed by existing work and recommendations from various projects on VAWG such as the Due Diligence Project, 2

3 WHO defines intimate partner violence as any behavior within an intimate relationship that causes physical, psychological or sexual harm to those in the relationship. Intimate partner violence is one of the most common forms of violence against women and includes physical, sexual, and emotional abuse and controlling behaviors by an intimate partner. Although domestic violence is used in many countries to refer to partner violence, it can also include abuse by any member of a household (for example, child or elder abuse). Violence related to sexual and reproductive health and rights is particularly harmful, adolescent girls and young women are disproportionately affected by violence related to their sexual and reproductive health and decision making over their bodies and lives. Violence is most frequently perpetrated within families, by intimate partners and known persons, not by strangers. Adolescent girls and young women are at especially high risk of sexual violence a very large part of sexual assaults are committed against girls under 16 years and many women and girls report that their first sexual experience was forced. Inadequate funding hinders comprehensive service provision. It could result in piecemeal approach, unsustainable and inconsistent levels and types of services. Ensuring adequate funding for services, well equipped facilities and monitoring and documentation of practices that work is an important component of ensuring accountability for violence against women and girls, and mechanisms for both response and prevention. Objective 2: Strengthen the capacity of health services and health-care providers to respond to violence Health care providers must receive continual training and undergo periodical evaluation to assess efficiency and competency. Health care providers and all the concerned agencies need to work to empower the survivors and to increase their confidence in the health services provided. It is important to equip health care providers with skills to effectively intervene in cases of VAWG and children. Violence or the threat of it, is amongst the most common reasons that women/girls provide for not using, or inability to negotiate, use of contraception. Health care providers ability to respond urgently and in a specific manner reduces the risk of further harm to survivors and inspires confidence to seek assistance specific to sexual and reproductive rights. Health service should focus on prevention of recurrence of further violence and ensuring that victims/survivors receive adequate and timely services. This includes ensuring the availability and accessibility of coordinated support services such as hotlines, shelters, medico-psycho social services and other services such protection orders based on strengthened coordination of services across different sectors. Medical and social support including psychological interventions is essential in protecting victims. Address all health consequences including the physical, mental and sexual and reproductive health consequences, of violence against women and girls by providing accessible health-care services that are responsive to trauma and include affordable, safe, effective and good-quality medicines, first line support, treatment of injuries and psychosocial and mental health support, emergency contraception, safe abortion where such services are permitted by national law, postexposure prophylaxis for HIV infection, diagnosis and treatment for sexually transmitted infections, training for medical professionals to effectively identify and treat women subjected to vio- 3

4 lence, as well as forensic examinations by appropriately trained professionals. 57th CSW para C (iii). Accelerate efforts to address the intersection of HIV and AIDS and violence against all women and girls, in particular the common risk factors, including through strategies to address domestic and sexual violence, and to strengthen coordination and integration of policies, programmes and services to address the intersection between HIV and violence against women and girls, and ensure that responses to HIV and AIDS are leveraged to prevent violence against them, while meeting their specific needs for sexual and reproductive health care services, as well as HIV and AIDS diagnosis, affordable and accessible treatment and prevention, including procurement and supply of safe and effective prevention commodities, including male and female condoms. 57th CSW (2013) para C (jjj) Provide well-funded shelters and relief support for girls and women subjected to violence, as well as medical, psychological and other counseling services and free or low-cost legal aid, where it is needed, as well as appropriate assistance to enable them to find a means of subsistence. Beijing PFA (1995) para 125(a) Objective 3: Strengthen the role and capacity of the health sector in programming to prevent violence Sexual and reproductive health services, the health services that are most likely to be available to women, provide key opportunities to reach women and girls subjected to, and at risk of violence. They can help prevent violence and have a critical role to play in raising awareness, identification of risk, mitigation and responses to violence. Strengthening of the multi-sectoral approach to handling VAWG and children to ensure seamless and coordinated efforts that complement each other. The effectiveness of strengthened health systems to prevent and respond to violence against women and girls, and children depends on the support of other sectors such as the police and judiciary in determining the support system for survivors. Implementing a multi-sectoral approached coordinated health services need a well funded tripartite relationship between medical services, the police and judiciary. Health outreach programs on VAWG broaden the social network for women and girls thereby increasing women s and girls autonomy and their ability to seek support from health facilities and seek assistance to stop violence. Well equipped medical centres staffed with trained personnel and supported by adequate funding can provide a more conducive environment for women and girls to seek medical assistance. Strengthened health systems are likely to provide a first step to survivors seeking further redress outside of the health services to ensure accountability for violence against women and girls. Objective 4: Improve research and evidence on violence Measures to address VAWG must be based on comprehensive, reliable data on prevalence, causes and consequences of VAWG. Data collection is important for shaping VAWG interventions; sex and age disaggregated data can provide insights to shape prevention measures and monitor and assess prevention programs. Violence does not affect all women, girls and children equally. Due to multiple and intersecting forms of discrimination certain groups of women, girls and children are more vulnerable 4

5 than others or face greater risks of violence than others. Such groups may also face greater challenges in accessing health services thereby exacerbating the consequences of violence. There is need for research on experiences of those discriminated on the basis of sexual orientation, gender identity, women working in informal settings such as domestic workers, sex workers, women with disabilities, women living with HIV and migrant women and girls. Mechanisms to monitor implementation, including qualitative surveys to ascertain the prevalence and forms of violence, could further ensure that such strategies remain current and effective. Including VAWG and children in national plans or the national health policies is an important component of monitoring what works and areas that need further research or improvement in implementation. Formatted: Font: (Asian) Palatino, Bold, (Intl) Palatino, Complex Script Font: Palatino, Bold Comment [u1]: Please add: Objective: 5 Strengthen the role of media in coverage and reporting of health issues to the public. Comment [u2]: Under Chapter 4: No D add Violence against Youth. 5